Costs of health care administration in the United States and Canada.

  title={Costs of health care administration in the United States and Canada.},
  author={Steffie Woolhandler and Terry Campbell and David Himmelstein},
  journal={The New England journal of medicine},
  volume={349 8},
BACKGROUND A decade ago, the administrative costs of health care in the United States greatly exceeded those in Canada. We investigated whether the ascendancy of computerization, managed care, and the adoption of more businesslike approaches to health care have decreased administrative costs. METHODS For the United States and Canada, we calculated the administrative costs of health insurers, employers' health benefit programs, hospitals, practitioners' offices, nursing homes, and home care… 

Health Care Administrative Costs in the United States and Canada, 2017

The gap in health administrative spending between the United States and Canada is large and widening, and it apparently reflects the inefficiencies of the U.S. private insurance-based, multipayer system.

The impact of health care reform on surgery.

  • D. Trunkey
  • Medicine, Political Science
    Advances in surgery
  • 2011

Where The Money Goes: The Evolving Expenses Of The US Health Care System.

Revenues and detailed expenditures for physicians' offices, hospitals, and outpatient care centers in 1997, 2002, 2007, and 2012 are calculated, using a range of Census Bureau and Bureau of Labor Statistics sources.

A comparison of hospital administrative costs in eight nations: US costs exceed all others by far.

This study suggests that the reduction of US administrative costs would best be accomplished through the use of a simpler and less market-oriented payment scheme.

US physician practices versus Canadians: spending nearly four times as much money interacting with payers.

The results support the opinion shared by many US health care leaders interviewed for this study that interactions between physician practices and health plans could be performed much more efficiently.

Comparing the Canadian and US systems of health care in an era of health care reform.

  • T. Lapierre
  • Political Science, Medicine
    Journal of health care finance
  • 2012
Canada fares better than the United States with regard to coverage, cost, and health outcomes, and underlying ideology, while overall access is better in Canada.

Medical Spending Differences in the United States and Canada: The Role of Prices, Procedures, and Administrative Expenses

  • A. PozenD. Cutler
  • Political Science, Medicine
    Inquiry : a journal of medical care organization, provision and financing
  • 2010
It is found that Canada spent $1,589 per capita less on physicians and hospitals in 2002 than it did in 2002, and administration accounted for the largest share of this difference.

Contributions of Public Hospitals to Regional Health Care: A Population-Based Analysis of the County Health Care System Serving Metropolitan Chicago

This county health care system is a productive contributor to overall health service delivery in Cook County, and its contributions exceed its proportionate funding in eight of nine priority health areas.

Billing and insurance-related administrative costs in United States’ health care: synthesis of micro-costing evidence

A simplified financing system in the U.S. could result in cost savings exceeding $350 billion annually, nearly 15% of health care spending, and befits a multiple-payer health care system.

The Complexity Of Billing And Paying For Physician Care.

This work develops new measures of billing complexity for physician care across insurers and over time, and estimates their costs using a large sample of detailed insurance "remittance data" for the period 2013-15, which found dramatic variation across different types of insurance.



The deteriorating administrative efficiency of the U.S. health care system.

The administrative structure of the U.S. health care system is increasingly inefficient as compared with that of Canada's national health program, and it accounts for about half the total difference in health care spending between the two nations.

Who administers? Who cares? Medical administrative and clinical employment in the United States and Canada.

If US hospitals and outpatient facilities adopted Canada's staffing patterns, 1,407,000 fewer managers and clerks would be necessary.

Costs of care and administration at for-profit and other hospitals in the United States.

Administrative costs as a percentage of total hospital costs increased in the United States between 1990 and 1994 and were particularly high at for-profit hospitals.

Administrative costs in U.S. hospitals.

Hospital administrative costs in the United States are higher than previous estimates and more than twice as high as those in Canada.

Does managed care mean more hassle for physicians?

  • D. RemlerB. GrayJ. Newhouse
  • Medicine, Political Science
    Inquiry : a journal of medical care organization, provision and financing
  • 2000
Overall, the findings contradict the widely held notion that managed care dramatically raises the administrative and insurance burden of physicians.

Proposal of the Physicians' Working Group for Single-Payer National Health Insurance.

A fundamental change in US health care is endorsed--the creation of an NHI program, which in essence would be an expanded and improved version of traditional Medicare, which would cover every American for all necessary medical care.

The costs of health care administration in the United States and Canada--questionable answers to a questionable question.

  • H. Aaron
  • Political Science, Medicine
    The New England journal of medicine
  • 2003
The authors report that the difference between the United States and Canada in outlays for health care administration seems to be increasing.

Effects of admission to a teaching hospital on the cost and quality of care for Medicare beneficiaries.

Although admission to a major teaching hospital may be associated with increased costs to the Medicare program, overall survival for patients with the common conditions the authors studied was better at these hospitals, especially for Patients with hip fractures.

Measuring the "managedness" and covered benefits of health plans.

Indexes of the managedness and benefits of health plans can be constructed from publicly available information and are associated with the personal characteristics and health status of study patients.

Inside the black box of administrative costs.

  • K. Thorpe
  • Political Science, Medicine
    Health affairs
  • 1992
This volume focuses on Canada, which administers a universal health insurance plan that is considerably less expensive than the private/public melange that makes up America's approach, although there is no agreement on the differential.